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Objective: Clarifying the distinctions between art-based creative activities in the domains of occupational therapy and art therapy in the context of stroke rehabilitation, while also describing the effects of art-based creative activities on stroke rehabilitation. Design: Scoping review. Data source: A systematic search was performed in nine databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL and four Chinese database) from their inception to December 2023. Review methods: The study included randomized and non-randomized controlled trials involving art-based creative activities, as well as qualitative research providing detailed intervention measures. The study focused on stroke patients, with primary outcomes related to patients' physiological recovery, psychological well-being, ADL, etc. Data extraction included information on intervention strategies and study results. Results: Seventeen studies were included, extracting six similarities and differences in creative activity between two domains. Creative activities were observed to have positive impacts on daily living activities, limb motor function, fine motor ability, and emotional well-being in stroke patients. Conclusion: Creative activities, whether in occupational therapy or art therapy, involve providing participants with tangible crafting materials for the creation of artistic works. Future stroke rehabilitation practices should tailor activities and intervention focus based on patients' rehabilitation needs, preferences, and cultural background. The current comprehensive analysis provides initial support for the potential positive role of creative activities in stroke rehabilitation, but further in-depth research is needed to confirm their effectiveness. [ABSTRACT FROM AUTHOR]

The article presents a research paper that examines effects of intervention of supermarkets on fruit and vegetable consumption in areas of limited retail access with reference to the findings of Intervention Study for Seacroft, Great Britain. The topics discussed include analysis of the findings of quantile regression, factors for low intake of food that include attitude towards healthy eating, relative cost of fruit and vegetables, and deprivation, and accessibility of food.

Background: Immunological responses to metal ions can occur in people with metal implantable devices. Nevertheless, patients are not routinely asked about metal hypersensitivity nor tested for it prior to surgical procedures. Moreover, we have not identified any published literature on patients' experiences with this condition. We undertook this study to better understand the experiences of patients with metal hypersensitivity and to determine what information would help them make an informed decision about implantable medical devices with metal compositions. Methods: This is a patient-oriented research using an interpretative phenomenological methodology. We enrolled 16 people from five countries (Canada, New Zealand, Spain, the UK, and the USA) who experienced metal hypersensitivity following implantable medical device. We collected data from in-depth, semi-structured interviews focused on pre-procedural patient education and postoperative experiences to elucidate the barriers and opportunities related to metal hypersensitivity. We analyzed the data using interpretative phenomenological analysis. Results: The majority were white biological women between the ages of 34 and 65. None of the participants were informed about immunological responses to metals in implants during the consenting process. They encountered many challenges when symptoms of metal hypersensitivity occurred. The outcomes for the few who had the implants removed were mixed. Conclusion: Hypersensitivity reactions to metal need to be discussed as part of the consenting process, and additional strategies are needed to mitigate this issue in the health system. [ABSTRACT FROM AUTHOR]

Background: Infection prevention competencies are critical for successful job performance, career progression and robust performance of infection prevention and control programs. Aim/objective: Identify competency assessment tools available to infection preventionists and describe their characteristics, validation processes and reliability. Methods: A scoping review was conducted on five databases and grey literature from 1999 to 2022. A descriptive synthesis approach was undertaken to analyse the data. Finding/results: Seven tools that meet the inclusion criteria were identified. Of those, one tool was reviewed twice. All tools were developed in the United Kingdom, Canada, China and the United States, and were published between 2009 and 2022. All tools use a rating scale; and the most used method to assess competencies was self-assessment. Levels of competency were cited by five tools. Two tools provided information on validation methods and reliability tests for internal consistency. Discussion: Few competency assessment tools are available in the literature, and there is a lack of information on their development process. A global effort to develop an assessment tool that allows comparison across countries and cultures can be a step forward to propel infection preventionists' careers and enhance the efficacy of Infection Prevention and Control Programs. [ABSTRACT FROM AUTHOR]

Technology-facilitated abuse (TFA) is a significant, harmful phenomenon and emerging trend in intimate partner violence. TFA encompasses a range of behaviours and is facilitated in online spaces (on social media and networking platforms) and through the misuse of everyday technology (e.g. mobile phone misuse, surveillance apps, spyware, surveillance via video cameras and so on). The body of work on TFA in intimate relationships is emerging, and so this scoping review set out to establish what types of abuse, impacts and forms of resistance are reported in current studies. The scoping review examined studies between 2000 and 2020 that focused on TFA within intimate partnerships (adults aged 18+) within the setting of any of these countries: the UK and Ireland, USA, Canada, New Zealand and Australia. The databases MEDLINE, CINAHL and Scopus were searched in December 2020. A total of 22 studies were included in the review. The main findings were that TFA is diverse in its presentation and tactics, but can be typed according to the eight domains of the Duluth Power & Control Wheel. Impacts are not routinely reported across studies but broadly fall into the categories of social, mental health and financial impacts and omnipresence. Similarly, modes of resistance are infrequently reported in studies. In the few studies that described victim/survivor resistance, this was in the context of direct action, access to legal or professional support or in the identification of barriers to resistance. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists can improve the quality of life of people receiving palliative care through the management of communication and swallowing difficulties (dysphagia). However, their role in this domain is poorly defined and little is understood about the current international professional practice in this field. Aims: To examine how speech and language therapists perceive their role in the delivery of palliative care to clients, to discover current international speech and language therapist practices and to explore the similarities and differences in speech and language therapists’ practice in palliative care internationally. This will inform professional clinical guidelines and practice in this area.Design:Anonymous, non-experimental, cross-sectional survey design.Participants:Speech and language therapists working with adult and paediatric palliative care populations in Republic of Ireland, United Kingdom, United States, Canada, Australia and New Zealand where the speech and language therapist profession is well established. Method: Purposive and snowball sampling were used to recruit participants internationally using gatekeepers. An online survey was disseminated using Survey Monkey (http://www.surveymonkey.com). Results: A total of 322 speech and language therapists responded to the survey. Speech and language therapist practices in palliative care were similar across continents. Current speech and language therapist practices along with barriers and facilitators to practice were identified. The need for a speech and language therapist professional position paper on this topic was emphasised by respondents. Conclusion: Internationally, speech and language therapists believe they have a role in palliative care. The speech and language therapist respondents highlighted that this area of practice is under-resourced, under-acknowledged and poorly developed. They highlighted the need for additional research as well as specialist training and education for speech and language therapists and other multidisciplinary team members in the area of palliative care. [ABSTRACT FROM AUTHOR]

Hemophilia is a bleeding disorder caused by a single absent/defective gene and characterized by a lack of functional clotting factors. People with hemophilia may experience joint damage, pain, and psychological impairments, all of which could contribute to reduced health-related quality of life (HRQoL). The current standard of care is clotting factor replacement, which is associated with regular infusions; therefore, alternative treatments such as gene therapy (GT) are in development. GT involves the delivery of a functional copy of the clotting factor 8/9 gene by a single infusion into the patient's cells, enabling them to produce their own clotting factor VIII/IX. The impact of treatment on patients' HRQoL can be assessed using hemophilia-specific patient-reported outcome (PRO) measures. Since these measures were designed before the advent of GT, there is a need for updated individualized PRO measures. Patient groups and regulatory authorities emphasize the need for increased patient engagement when considering clinical trial design. Here, we provide patients' perspective on undergoing GT and discuss how to capture the patient voice when measuring the therapy's transformative impact. [ABSTRACT FROM AUTHOR]

Relationships between siblings have been described as the longest lasting an individual can have, yet siblings both can and do become estranged from one another in adulthood. An online survey was disseminated to individuals who had sought support from the charity Stand Alone, which supports individuals who are experiencing family estrangement. Individuals estranged from one full genetic sister and/or brother were asked to describe the relationship in their own words. Open-text responses were thematically analysed from 291 respondents. Family systems were described as being characterised by estrangements, alliances and conflicts; there was variation in the participant's preferences regarding reconciliation; and most respondents focused on describing their sibling's challenging or disappointing characteristics and behaviour. The fact that siblings both can and do become estranged challenges commonly held assumptions about family relationships, confirming that they are not necessarily or always life-long, significant or supportive. [ABSTRACT FROM AUTHOR]

Large scale, open immigration of unaccompanied dependent children to Canada did not commence until 1869, but it had been advocated for decades and some such immigration to the British North American colonies took place earlier in the century. The first systematic emigration of destitute British children was organized in the 1830s by the Children's Friend Society, which sent about 141 children to the Canadas from 1833 to 1836, at least 70 of whom went to Upper Canada. While the emigration scheme was short lived, it established that such children would be welcomed and that homes and work would be available for them, and it probably helped pave the way for a new wave of older juvenile immigrants in the 1850s, and for the high profile, large scale immigration of young dependent children that began in 1869 and continued for more than half a century. [ABSTRACT FROM AUTHOR]

This paper explores the process of elite sport policy change in two sports (swimming and track and field athletics) and their respective national sport organizations (NSOs) in Canada and national governing bodies of sport (NGBs) in the United Kingdom (UK). The nature of policy change is a complex and multifaceted process and a primary aim is to identify and analyse key sources of policy change through insights provided by the advocacy coalition framework (ACF). In Canada, it is evident that the preoccupation with high performance sport over the past 30 years, at federal government level, has perceptibly altered over the past two to three years. In contrast, in the UK, from the mid-1990s onwards, there has been a noticeable shift towards supporting elite sport objectives from both Conservative and Labour administrations. Most notably, the ACF throws into sharp relief the part played by the state in using its resource control to shape the context within which debates on beliefs and values within NSOs/NGBs takes place. While the ACF has proved useful in drawing attention to the notion of changing values and belief systems as a key source of policy change, as well as highlighting the need to take into account factors external to the policy subsystem under investigation, potential additions to the framework's logic are suggested for future applications. [ABSTRACT FROM AUTHOR]

A remarkable study was carried out during the Second World War on the feasibility of building large ships from ice. It received support at the highest political level because of the need for floating platforms to support aircraft operations. Extensive investigations were carried out on the mechanical properties of plain and reinforced ice and on the structural and operational characteristics of the proposed vessels. Investigations on methods for reinforcing ice led to the development of 'pykrete', a frozen mixture of water and wood pulp that was appreciably stronger and tougher than plain ice. The studies on the structural and operational characteristics of the vessels showed that the work required to design, construct and demonstrate the effectiveness and safety of the ships would be far greater than originally thought. This paper gives an abbreviated description of the work that was done, based on project files in Great Britain and Canada, which led to the conclusion that it was technically possible to build ships from ice, but that during wartime it would be too costly in terms of manpower and strategic materials. [ABSTRACT FROM AUTHOR]

People affected by rarer forms of dementia often have a long and difficult experience obtaining a diagnosis and appropriate support, impacting family, employment and social relationships, quality of life and wellbeing. For this population progressive cognitive symptoms affect skills other than memory and disproportionately occur under the age of 65 years, often resulting in misdiagnosis and lack of appropriate care pathways. The objective of this study will be to better understand the subjective experience of the time period from first noticing symptoms to obtaining a formal diagnosis, through to accessing support, and onward to the present time. Through the concurrent use of line drawings and video-recorded interviews we will collect the stories of people living with different rarer dementias and/or family members who are care partners in Canada and the United Kingdom. Narrative and visual analysis will be used in parallel to methodologically explore how line drawing and verbal discourse interact and inform each other to construct knowledge, and how the use of drawing lines might enrich research interviews and increase accessibility of research participation. This novel research approach may also have implications for clinical interviewing, support services, and public engagement. To the best of our knowledge, this is the first study to retrospectively explore over time the experiences of people affected by rarer forms of dementia from initial symptoms—to diagnosis—to accessing support—to the present, using visual and verbal methodologies. [ABSTRACT FROM AUTHOR]

Background: People who use drugs with life-limiting illnesses experience substantial barriers to accessing palliative care. Demand for palliative care is expected to increase during communicable disease epidemics and pandemics. Understanding how epidemics and pandemics affect palliative care for people who use drugs is important from a service delivery perspective and for reducing population health inequities. Aim: To explore what is known about communicable disease epidemics and pandemics, palliative care, and people who use drugs. Design: Scoping review. Data sources: We searched six bibliographic databases from inception to April 2021 as well as the grey literature. We included English and French records about palliative care access, programs, and policies and guidelines for people ⩾18 years old who use drugs during communicable disease epidemics and pandemics. Results: Forty-four articles were included in our analysis. We identified limited knowledge about palliative care for people who use drugs during epidemics and pandemics other than HIV/AIDS. Through our thematic synthesis of the records, we generated the following themes: enablers and barriers to access, organizational barriers, structural inequity, access to opioids and other psychoactive substances, and stigma. Conclusions: Our findings underscore the need for further research about how best to provide palliative care for people who use drugs during epidemics and pandemics. We suggest four ways that health systems can be better prepared to help alleviate the structural barriers that limit access as well as support the provision of high-quality palliative care during future epidemics and pandemics. [ABSTRACT FROM AUTHOR]

A content analysis of values in dominant culture magazines in the United States, Canada and Great Britain during 1957-59, 1967-69 and 1970-72 indicated a priority on instrumentalism and little shifting in overall value preference over time. This appears to be contrary to predictions made by counterculture observers that Western society was changing rapidly toward a countercultural ideology. A similar analysis of the underground press in the same countries during 1967-69 and 1970-72 revealed a marked shift from expressive priorities during the earlier period to political priorities during the later period. These findings and their implications are discussed. [ABSTRACT FROM AUTHOR]

Brivudin, ((E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) can be considered the gold standard for the treatment of varicella-zoster virus (VZV) infections, such as herpes zoster (shingles). It is available for clinical use in most European countries (except for the UK) and over the whole world (except for the US and Canada). Besides VZV its activity spectrum also includes various other herpesviruses, such as herpes simplex virus type 1 (HSV-1). Its activity against VZV and HSV-1 depends on phosphorylation by the virus-encoded thymidine kinase (TK). In its active form (BVDU TP or BVDU 5'-triphosphate), it can act as both substrate and inhibitor of the viral (i.e., HSV-1) DNA polymerase. It has proven to be effective against herpes zoster, including post-herpetic neuralgia (PHN). It is contra-indicated in patients concomitantly treated by 5-fluorouracil (FU), since its degradation product, (E)-5-(2-bromovinyl)uracil, is inhibitory to the catabolism of FU, which may enhance the toxicity of the latter. A new compound, the bicyclic nucleoside analogue (BCNA) Cf-1743, has been described, which is a more potent inhibitor of VZV replication than BVDU and which does not interfere with the catabolism of FU. It is applicable orally, as its 5'-valine ester FV-100 (Fermavir), but has not (yet) been marketed for clinical use. [ABSTRACT FROM AUTHOR]

Background: Family caregivers provide the majority of palliative care. The impact of family caregiving on employment and finances has received little research attention in the field of palliative care. Aim: The aim of this study was to explore perspectives and experiences of combining paid employment with palliative care family caregiving, and to assess the availability and suitability of employment support across three countries – the United Kingdom (UK), Aotearoa New Zealand and Canada. Design: A qualitative descriptive study design was used. Semi-structured interviews were held with 30 key informants with professional or personal experience in palliative care from the UK (n = 15), Aotearoa New Zealand (n = 6) and Canada (n = 9). Interviews were recorded, transcribed and analysed using the principles of thematic analysis. Results: Four main themes were identified: (1) significant changes to working practices are required to enable end of life family carers to remain in work; (2) the negative consequences of combining caregiving and employment are significant, for both patient and carer; (3) employer support for working end of life caregivers is crucial but variable and; (4) national, federal and government benefits for working end of life family carers are necessary. Conclusion: Supporting carers to retain employment whilst providing care has potential benefits for the patient at end of life, the caregiver, and the wider economy and labour market. Employers, policymakers and governments have a role to play in developing and implementing policies to support working carers to remain in employment. [ABSTRACT FROM AUTHOR]

Background/Context: On January 29, 2008 the Toronto District School Board (TDSB) approved a city-wide Africentric elementary school under their Alternative School policy, sparking a contentious debate. Calls for Black-focused schools also arose in 2008 in London in response to the disengagement of African Caribbean youth. The historical record indicates, however, that community campaigns for Black educational programs stretch back over 40 years in both cities. Focus of the Study: This paper analyzes the development of Black-focused education in Toronto and London from 1968 to 2008 through the responses of Black parents and community activists to the historic underachievement of African Caribbean students (particularly males) in the public schools of both cities. Black-focused education is situated within the larger social, political, and national contexts and the critical incidents that fueled the development of race equality policy. The article explores how the "politics of place" influenced the trajectory of Black-focused education in each city. Research Methodology: Two parallel historical case studies were conducted using primary source material from community-based archives, secondary sources on the history of African Caribbean immigration and the development of Black community organizations, and oral history interviews with 10 Black education activists in Toronto and 7 activists in London. Conclusions: This comparative study conceptualizes this transnational phenomena as "resistance to racism" and examines how Black-focused curriculum and ideology was adapted to local conditions in Canada and Britain. Parents and community activists aimed to develop the citizenship rights of African Caribbean students, establish a diasporic sensibility, and promote the right of children of African descent to a quality education wherever they may reside. [ABSTRACT FROM AUTHOR]

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At the outset of the Thatcher/Reagan era, the employment and labor law systems across six Anglo- American countries could be divided into three pairings: the Wagner Act model of the United States and Canada; the Voluntarist system of collective bargaining and strong unions in the United Kingdom and Ireland; and the highly centralized, legalistic Award systems of Australia and New Zealand. The authors argue that there has been growing convergence in two major areas: First, of labor law toward a private ordering of employment relations in which terms and conditions of work and employment are primarily determined at the level of the enterprise; and second, of individual employment rights, toward a basket of minimum standards that can then be improved upon by the parties. The greatest similarity is found in Canada, the United Kingdom, New Zealand, and Australia. Ireland retains a greater degree of public ordering, while the United States diverges in favoring the interests of employers over those of employees and organized labor. The authors explore reasons for the convergence. [ABSTRACT FROM AUTHOR]

The clinical symptoms of dementia include difficulty with speech, poor short-term memory, and changes in behavior. These symptoms can affect how the person with dementia understands and performs in social interactions. This qualitative review investigated how people with mild to moderate dementia managed social connections. A systematic search of social science databases retrieved 13 articles; data were synthesized using thematic analysis. Results established the work undertaken by people with dementia to maintain and present a social persona seen as socially acceptable. Interpretations are contextualized within Goffman and Sabat's theories on "self." People with dementia were agentic in impression management: undertaking work to maintain recognized social roles, while being aware of when their illness led to others discrediting them. Wider recognition of strategies used to maintain a social self could inform interventions designed to increase capability and confidence in co-managing social connections following dementia diagnosis. [ABSTRACT FROM AUTHOR]

Background: Family caregivers of people at the end of life can face significant financial burden. While appropriate financial support can reduce the burden for family caregivers, little is known about the range and adequacy of financial support, welfare and benefits for family caregivers across countries with similarly developed health care systems. Aim: The aim is o identify and compare sources of financial support for family caregivers of people approaching the end of life, across six countries with similarly performing health care systems (Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States). Design: A survey of financial support, welfare and benefits for end of life family caregivers was completed by 99 palliative care experts from the six countries. Grey literature searches and academic database searches were also conducted. Comparative analyses of all data sources documented financial support within and between each country. Results: Some form of financial support for family caregivers is available in all six countries; however the type, extent and reach of support vary. Financial support is administered by multiple agencies, eligibility criteria for receiving support are numerous and complex, and there is considerable inequity in the provision of support. Conclusion: Numerous barriers exist to the receipt of financial support, welfare and benefits. We identified several areas of concern, including a lack of clarity around eligibility, inconsistent implementation, complexity in process and limited support for working carers. Nonetheless, there is significant potential for policymakers to learn from other countries' experiences, particularly with regard to the scope and operationalisation of financial support. [ABSTRACT FROM AUTHOR]

It is frequently of interest to estimate the time that individuals survive with a disease, that is, to estimate the time between disease onset and occurrence of a clinical endpoint such as death. Epidemiologic survival data are commonly collected from either an incident cohort, whose members' disease onset occurs after the study baseline date, or from a cohort with prevalent disease that is followed forward in time. Incident cohort survival data are limited by study termination, while prevalent cohort data provide biased (left-truncated) survival data. In this article, we investigate the advantages of a study design featuring simultaneous follow-up of prevalent and incident cohorts to the estimation of the survivor function. Our analyses are supported by simulations and illustrated using data on survival after myotonic dystrophy diagnosis from the United Kingdom Clinical Practice Research Datalink (CPRD). We demonstrate that the NPMLE using combined incident and prevalent cohort data estimates the true survivor function very well, even for moderate sample sizes, and ameliorates the disadvantages of using a purely incident or prevalent cohort. [ABSTRACT FROM AUTHOR]

The first decade of the new millennium saw the governments of Canada and the United Kingdom enact criminal legislation intended to hold corporations accountable for negligently killing workers and/or members of the public. Drawing empirically from document analyses and semistructured interviews, as well as theoretical insights concerning the crisis-prone tendencies of capital, this article demonstrates how both laws were conceived in ways that spatio-temporally delimited the 'problem' of corporate killing and re-secured the (neoliberal) capitalist status quo. In so doing, we argue that the inability of the state to hold powerful corporations and corporate actors to account for their serious offending presents strategic opportunities for demanding improved accountability measures and changes to a system responsible for so much bloodshed and killing. [ABSTRACT FROM AUTHOR]

This comparative study examines survey data from 464 call centers in the United States, 167 in the United Kingdom, and 387 in Canada to explore two questions: whether institutional differences shape employers' choices of ways to improve work force flexibility, both numerical and functional; and whether strategies for numerical flexibility and functional flexibility are related. The results suggest that institutional differences across these liberal market economies--specifically, in dismissal regulations and union strength--did affect how employers chose to achieve work force flexibility. For example, the use of part-time workers was more common in countries with more stringent rules regulating dismissals. Organizational characteristics also mattered, with outsourced firms being more likely than in-house firms to use part-time workers. Evidence also suggests that managers used numerical flexibility and functional flexibility strategies as substitutes: higher employee job discretion was associated with both lower dismissal rates and a lower likelihood of temporary use. [ABSTRACT FROM AUTHOR]

Theater-based interventions are a viable prevention strategy for changing sexual health knowledge, attitudes, and behaviors related to HIV prevention. However, few studies have explored interventions in English-speaking, high-income countries such as the United States, Canada, or the United Kingdom. This article critically reviews the literature to identify key characteristics of theater-based HIV prevention strategies used for adolescents in school-settings in the United States, Canada, and the United Kingdom. Specifically, we identify the theatrical approach used in HIV prevention interventions, the behavioral theories that inform such interventions, and the study design and results of existing evaluation studies conducted in school settings. In the 10 articles reviewed, we found limited grounding in theory and the use of nonrigorous study design. To strengthen the evidence and practical application of theater-based HIV prevention interventions, we highlight three specific recommendations for practitioners and researchers: (1) define and operationalize the theater approach and techniques used, (2) ensure theater-based interventions are grounded in theory, and (3) conduct rigorous evaluation of theater-based interventions. These recommendations are key to strengthening future research on and implementation of theater-based interventions for HIV prevention. [ABSTRACT FROM AUTHOR]

Domestic/Family Violence Death Reviews (D/FVDRs) have been established in a number of high-income countries since 1990 as a mechanism to inform prevention-focused interventions to reduce domestic/family violence. D/FVDRs differ in their structure, governance, case identification processes and inclusion criteria, review measures, and outputs. Outside of the United States, the extent of heterogeneity across and within countries has not been explored. This study comprised an international comparison of D/FVDRs and their core elements to inform the establishment of D/FVDRs in other developed countries, and potentially low- and middle-income countries where violence is a leading cause of death. Such a review is also a necessary foundation for any future evaluation D/FVDRs. The review identified 71 jurisdictions where a D/FVDRs had been established in the past two decades, 25 of which met the inclusion criteria. All D/FVDRs examined stated a reduction in deaths as a goal of the review process; however, none reported an actual reduction. The focus of the D/FVDRs examined was on intimate partner homicides; however, more recently established D/FVDRs include other familial relationships. Almost one third of the D/FVDRs examined reported changes to the domestic/family system that occurred as a result of recommendations made from the review process. While similar in many ways, D/FVDRs differ along a number of important dimensions that make it difficult to identify best practices for jurisdictions considering the establishment of such an initiative. To share knowledge, existing networks should be expanded nationally and internationally to include jurisdictions that may be considering this initiative. [ABSTRACT FROM AUTHOR]

The article discusses a study on the perception of nursing students/ educators on the contribution of ethics education to ethical competence of nursing students. It addresses questions including how they look at general contribution of ethics education, contribution of ethics education to ethical competence and features of ethics education needed to promote ethical competence. It suggests that ethics education adds to the ethical awareness and ethical reasoning competencies of nursing students.

The purpose of this article is to provide specific recommendations to enhance physician engagement in health care organizations. It summarizes the evidence on physician engagement, drawing on peer-reviewed articles and reports from the gray literature, and suggests an integrative framework to help health care managers better understand and improve physician engagement. While we examine some other international examples and experiences, we mainly focus on physician engagement in Canada, the United States, and the United Kingdom. Physician engagement can be conceptualized as an ongoing two-way social process in which both the individual and organizational/cultural components are considered. Building on several frameworks and examples, we propose a new integrative framework for enhancing physician engagement in health care organizations. We suggest that in order to enhance physician engagement, organizations should focus on the following strategies: developing clear and efficient communication channels with physicians; building trust, understanding, and respect with physicians; and identifying and developing physician leaders. We propose that the time is now for health care managers to set aside traditional differences and historical conflicts and to engage their physicians for the betterment of their organizations. [ABSTRACT FROM AUTHOR]

This article examines how the telephone-hacking scandal involving Rupert Murdoch's media group in Great Britain reflects some of the strengths and weaknesses of the Canadian media industry. It is noted that the controversy reminds of the influence of Murdoch's media on journalism. Also mentioned how the scandal indicates the continued political relevance of the so--called legacy media in the digital era.

Intimate partner violence (IPV) is a global public health concern with significant physical, emotional, and economic costs. Persuading IPV perpetrators to change their behavior could play an important role in ending violence. This article reviews and analyzes 16 campaigns targeting IPV perpetrators, created in the United States, Canada, United Kingdom, Australia, and New Zealand. Two well-known models, the Transtheoretical (Stages of Change) model and Protection Motivation theory (PMT), are combined to create the analytical framework. For each stage of change, the most salient PMT variables are outlined, the people found in that stage are described, and the most effective strategies for persuasion are posited. Together, these two models would suggest that future campaigns targeting IPV perpetrators should place a stronger emphasis on the benefits of changing and place a greater focus on increasing perpetrators’ confidence that they can abstain from violence. [ABSTRACT FROM PUBLISHER]

Low employment rates of chronically ill and disabled people are of serious concern. Being out of work increases the risk of poverty and social exclusion, which may further damage the health of these groups, exacerbating health inequalities. Macro-level policies have a potentially tremendous impact on their employment chances, and these influences urgently need to be understood as the current economic crisis intensifies. In Part I of this two-part study, the authors examine employment trends for people who report a chronic illness or disability, by gender and educational level, in Canada, Denmark, Norway, Sweden, and the United Kingdom in the context of economic booms and busts and deindustrialization. People with the double burden of chronic illness and low education have become increasingly marginalized from the labor market. Deindustrialization may have played a part in this process. In addition, periods of high unemployment have sparked a downward trend in employment for already marginalized groups who did not feel the benefits when the economy improved. Norway and Sweden have been better able to protect the employment of these groups than the United Kingdom and Canada. These contextual differences suggest that other macro-level factors, such as active and passive labor market polices, may be important, as examined in Part II. [ABSTRACT FROM AUTHOR]

Coverage with evidence development (CED) has been developed as a response to the uncertainty in evidence when new technologies, including pharmaceuticals, are introduced into the market. Rather than deny coverage for these technologies or grant them unlimited coverage, CED attempts to ensure that patients' access to new medications is not prevented but is managed in a coordinated way, while also generating additional evidence to reduce any uncertainty about the value of the medications. CED projects are currently operating in Australia, Canada, the United Kingdom, and the United States. However, decision-making about these projects is haphazard, and basic information about the projects is not publicly available. As a new policy development there are many unanswered policy questions, and no organized comprehensive strategy seems to be in place in any country for resolving these questions. Until these policy issues have been addressed, CED will have difficulty achieving its potential. [ABSTRACT FROM AUTHOR]

Introduction: Occupation-focused models are one method of integrating occupation into occupational therapy education programmes. They offer a theoretical basis for practice by providing explanations about the process and practice of the profession. Method: This exploratory study used a quantitative research framework to investigate which occupation-focused models are included in occupational therapy programmes, the rationale for their inclusion and how the models are integrated into curricula. A survey was sent to 193 occupational therapy programmes in Australia, Canada, the United Kingdom and the United States. Results: The response rate was 33.8% (n = 65). The data showed that each programme included between 3 and 10 occupation-focused models. The Canadian Model of Occupational Performance and Engagement and the Model of Human Occupation were included in 98.5% of all curricula surveyed. Conclusion: The educators used a multilayered decision-making process to determine which occupation-focused models to include in a curriculum. The instructional methods varied, but most programmes used practice placement education as a teaching strategy. Further research is required into how curriculum design influences a practitioner's future use of occupation-focused models in practice. A better understanding is needed of how professional practice education affects students' values and attitudes towards the use of occupation-focused models. [ABSTRACT FROM AUTHOR]

Circles of Support & Accountability (COSA) started 15 years ago in Ontario, Canada, as an alternate means of social support to high-risk sexual offenders released at the end of their sentences without any community supervision. The pilot project in South-Central Ontario has since assisted almost 200 offenders. Projects based on this model are now in place in the United Kingdom, several jurisdictions in the United States, and throughout Canada. Initial research into the efficacy of the COSA pilot project showed that participation reduced sexual recidivism by 70% or more in comparison with both matched controls and actuarial norms. The current study sought to replicate these findings using an independent Canadian national sample. A total of 44 high-risk sexual offenders, released at sentence completion and involved in COSA across Canada, were matched to a group of 44 similar offenders not involved in COSA. The average follow-up time was 35 months. Recidivism was defined as having a charge or conviction for a new offense. Results show that offenders in COSA had an 83% reduction in sexual recidivism, a 73% reduction in all types of violent recidivism, and an overall reduction of 71% in all types of recidivism in comparison to the matched offenders. These findings suggest that participation in COSA is not site-specific and provide further evidence for the position that trained and guided community volunteers can and do assist in markedly improving offenders' chances for successful reintegration. [ABSTRACT FROM AUTHOR]

The author reflects on the content of Canadian mass-market magazines "Chatelaine," and "Canadian Home Journal," and offers an analysis of the short story "Lady Going West." The author comments of the relation of these literature with the Second World War. The author opines on the role of the literature in constructing femininity during the war and in presenting Canada as national entity within an international community. The author emphasizes Canada's relationship with Great Britain.

This historical research describes the life and work of Thomas Bessell Kidner (1866-1932). The purpose of the article is threefold: to describe Kidner's British heritage, to suggest how Kidner's background may have influenced his contributions to the early development of the profession, and to examine how Kidner's contributions have influenced practice. Using methods appropriate to interpretive biography, primary and secondary source materials have been gathered and analysed relating to Kidner's education and early work experiences in England; his work in Canada, teaching manual training and as Vocational Secretary during the First World War; and his time in the United States, with particular reference to his role with the American Occupational Therapy Association. The analysis suggests that Kidner brought the ideology of educational reform, as manifested in manual training, into occupational therapy and that this work provided a foundation for his approach to the treatment of injured soldiers. Kidner's efforts to help the profession to survive and expand after the war, with the consequent alignment with medicine, are also highlighted. His contact with the profession and with key individuals, such as Elizabeth Casson, in the United Kingdom is also explored. Finally, Kidner's contributions are considered in the light of how the profession might have developed had circumstances been different. [ABSTRACT FROM AUTHOR]

There is a long-standing argument that in Westminster-style systems parliaments are in decline. The frequency with which the head of government intervenes in parliament is one indicator of this supposed decline. Studies conducted in Britain and Canada show that the frequency of prime ministerial interventions has declined over time, suggesting that the decline of parliament thesis holds true in this regard at least. This article examines the Irish case and shows that the situation is different. As in Britain and Canada, there has been a decline in particular forms of activity. However, the overall level has increased over time. These findings suggest that in the Irish case at least and on the basis of this one indicator the decline of parliament thesis does not hold true. Moreover, when we contextualise the findings, particularly on the basis of a qualitative analysis of the changing nature of the presentation of the Order of Business over the last 30 years, we find that the decline of parliament thesis is weakened further. Thus, this article suggests that the decline of parliament thesis is not applicable to all examples of Westminster-style parliamentary systems. [ABSTRACT FROM AUTHOR]

This study assesses whether civic association activity has declined in four Western democracies: Canada, the Netherlands, the United Kingdom, and the United States. Influential accounts of decreasing civic engagement in the United States lead to the expectation of similar patterns in the other three nations. The authors test this hypothesis using data from time-use surveys of adult national samples for the mid-1960s to the late 1990s. One major finding is a clear decline in association activity in the United States, especially after 1975, but relative stability in the other three countries. Equally important are further results indicating that the American decline pertains only to women. Findings are sustained even after controlling for social background characteristics and four other activities (television watching, paid work, childcare, and physical activity). The analysis casts doubt on the theory that declining civic association activity in the United States reflects generational differences. Possible explanations for the reduced activity among American women, including lower levels of state support, are considered. [ABSTRACT FROM AUTHOR]

This article considers what the notions of empowerment, rights and citizenship imply in the way of structures and policies. It argues that a coherent model is emerging with recognizable elements. The article begins with a brief discussion of some background and theoretical questions. It then examines four elements: support for people to articulate their claims; support for people to identify, obtain and manage supports necessary to actualize their claims; providing control over resources; and governance. Examples will be drawn primarily from the UK and British Columbia, Canada to illustrate the elements. The article then looks at some of the issues related to successful implementation of a rights or empowerment based model of policy and structures for supporting people labelled as having a learning disability. [ABSTRACT FROM AUTHOR]

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This article presents a brief summary of articles related to libraries and information science, published in several periodicals. Reports on an international video-conferencing forum hosted by the British Council on the role of libraries in bridging the digital divide. Purposed to report to IFLA, librarians from Canada, Great Britain, South Africa and India explored parallels between experience of the divide in the two hemispheres. Themes covered include a definition of the digital divide and training provision for librarians to address inequalities. There is over 20 years of accumulated cross-country evidence of the link between telecommunications provision and economic growth. Looking at micro-studies from a range of countries including Bangladesh, Botswana and Zimbabwe, there is also some evidence that provision of telephony has a dramatic effect on the income and quality of life of the rural poor. Information is a resource for development. It is vital for every aspect of personal and working lives. Libraries have traditionally been among the foremost repositories in the dissemination of information. But the ways in which they fulfil these roles are rapidly altered by modern technologies.

This study reviews recent innovations in three countries--Canada, Great Britain, and the U.S.--toward the provision of education and training for labor's professional staff, officials, and leaders. It highlights the overall approach and several of the initiatives adopted in each country, and then discusses some opportunities and barriers toward the development of this important facet of labor education. It complements recent discussions about the forms and purposes of labor education, in general, and current debates about the revitalization of the labor movement. The study concludes with a call for more systematic discussion of these issues and further analysis of different approaches. [ABSTRACT FROM AUTHOR]

Study Objective. Suicide is a serious health problem that is shaped by a variety of social and mental health factors. A growing body of research connects the arts to positive health outcomes; however, no previous systematic reviews have examined the use of the arts in suicide prevention and survivorship. This review examined how the arts have been used to address suicide prevention and survivorship in nonclinical settings in Australia, Canada, the United Kingdom, and the United States of America. Design and Setting. Ten bibliographic databases, five research repositories, and reference sections of articles were searched to identify published studies. Articles presenting outcomes of interventions conducted between 2014 and 2019 and written in English, were included. Primary Results. Nine studies met inclusion criteria, including qualitative, quantitative randomized controlled trials, quantitative nonrandomized, quantitative descriptive, and mixed-methods studies. The programs studied used film and television (n = 3), mixed-arts (n = 3), theatre (n = 2), and quilting (n = 1). All nine interventions used the arts to elicit emotional involvement, while seven also used the arts to encourage engagement with themes of health. Study outcomes included increased self-efficacy, awareness of mental health issues, and likelihood for taking action to prevent suicide, as well as decreases in suicidal risk and self-harming behaviors. Conclusions. Factors that influence suicide risk and survivorship may be effectively addressed through arts-based interventions. While the current evidence is promising with regard to the potential for arts programs to positively affect suicide prevention and survivorship, this evidence needs to be supplemented to inform recommendations for evidence-based arts interventions. [ABSTRACT FROM AUTHOR]

The desire for more effective indicators of well-being is best reflected in the "social indicators movement" which began in the United States in the mid-sixties and has since spread to embrace Great Britain, Canada and Japan. The rapid expansion of interest in the development of social indicators has, not surprisingly, produced numerous problems of definition, measurement and integration which have not yet been resolved. Furthermore, the term "social indicator" has become devalued with increasingly more generous interpretations, so that even the most modest of statistical series have become so named. It has been suggested that the term should be restricted to those measures which can be related to a sociological model of some kind. Much of the past neglect of the importance and potential of the concept must be attributed to confusion over terminology and definitions. Researchers tended to work to their own definitions of standard of living, level of living, plane of living, satisfaction of consumption and norm of living, whilst in the course of time the problem has been compounded by the popular usage of "standard of living" and, more recently, of "quality of life" as terms synonymous with most of these concepts.

We examine gender differences in the relative poverty of men and women in eight industrialized countries. The analyses are based on data from the Luxembourg Income Study, which includes data from the United States, Canada, Australia, the United Kingdom, West Germany, Sweden, Italy, and the Netherlands. We examine the importance of the gender-specific demographic compositions of marriage, parenthood, and employment in accounting for differences in men's and women's poverty rates, both within and across countries. The cross-national comparisons suggest that the relative importance of demographic characteristics differs by country and that factors such as religion, culture, and government policies also help determine the gap between women's and men's poverty rates. [ABSTRACT FROM AUTHOR]